The 8th Annual CCNM Research Day: Student Research & Innovation in Naturopathic Medicine

: The following are abstracts from the research competition at the 8th annual CCNM Research Day hosted by the Canadian College of Naturopathic Medicine in New Westminster, BC, Canada and Toronto, ON, Canada. The conference celebrates high quality student–faculty research collaborations, showcased as poster presentations.


Conference Abstracts
Note: These abstracts have been reproduced directly from the material supplied by the authors, without editorial alteration by the staff of the URNCST Journal.Insufficiencies of preparation, grammar, spelling, style, syntax, and usage are the authors.

Myelodysplastic Syndrome and Hemoglobin Improved by Intravenous Nutrient Therapy: A Case Report
Onkar Singh, ND [1,2], Mary-Leah Albano, MPH, ND [1], Felicia Scaringi, BSc [2], Monique Aucoin, ND, MSc [2,3] [1] Holistic Healing Arts, Brantford, Ontario, Canada [2] Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada [3] University of Guelph, Guelph, Ontario, Canada Myelodysplastic Syndromes (MDSs) are variations of bone marrow failure disorders that lead to insufficient production of healthy blood cells culminating in some combination of low red blood cells, low white cells or both.This case report presents a case of increased hemoglobin levels following intravenous (IV) vitamin/mineral therapy.JB is a 74-year-old male who presented with a chief concern of MDS.As a result of this condition, he was experiencing extreme fatigue and exhaustion, episodes of shortness of breath and a decline of hemoglobin levels.He was being followed by a hematologist who monitored his CBC at regular intervals, with a primary focus on blood hemoglobin levels.His hemoglobin levels were significantly lower than the normal range, however they never fell below 75 g/dL, the threshold for a blood transfusion and his only treatment option.Beginning in November 2021, weekly to biweekly IV vitamin/mineral therapy treatments were initiated.Thirty-nine IV treatments were given in all until August 2023.IV nutrient formulas included Meyer's Cocktail, High Dose Vitamin C (25gm), Hydrating Meyer's Cocktail and Meyer's Cocktail + glutathione.As IV treatments were being provided, JB's blood hemoglobin levels were assessed regularly by his hematologist.A trend was observed showing a consistent improvement of hemoglobin levels over time.The greatest degree of hemoglobin value improvement was observed after the series of Hydrating Meyer's Cocktails.In addition, the patient reported improved overall fatigue and a decrease in recovery time from activity.Delivering a series of IV infusions may have resulted in an improvement of hemoglobin levels in this patient.Further investigation is warranted to understand the potential IV nutrient therapy could have on MDS patients with a similar prognosis.
Funding Sources: No funding was received for the conduct of this research.

Conflicts of Interest:
The authors have no conflicts of interest to declare.

Assessing the Effects of Carnitine and Coenzyme Q10 Supplementation on Sperm Quality: A Narrative Review
Laura Hill, CCNM Student [1], Adam Gratton, MSc, ND [1] [1] Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada Background: Infertility is often considered a female condition, with considerable attention being given to women's reproductive health and research on male infertility is limited.However, one third of infertility cases are caused by "male factor" infertility, and approximately 2% of all men will exhibit suboptimal sperm parameters.Nutritional factors play a crucial role in sperm health and male fertility.The application of interventions has the potential to be an affordable, efficient, and easily implementable treatment for male infertility.The evidence for safety and efficacy of two interventions will be summarized in this review: L-carnitine/acetyl-L-carnitine and coenzyme Q10 (CoQ10).

Vitamin D and Probiotics for the Treatment of Atopic Dermatitis in Children: A Narrative Review
Jeanette Titus, CCNM Student [1], Adam Gratton, MSc, ND [1] [1] Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada Background: Atopic dermatitis (AD) is a persistent and chronic itchy skin condition that can severely impact quality of life.The prevalence of AD in children is 10-20%, costing $1.4 billion annually with the prevalence increasing in industrialized countries.While corticosteroids and other topical and systemic agents can be effective, they are not free of adverse effects.With the prevalence of corticosteroid phobia, many seek alternative methods of treatment.This study aims to appraise the evidence for two specific non-drug interventions: vitamin D and probiotics.Methods: PICO criteria were defined before conducting the literature search.Population had to be children with AD.Interventions were vitamin D and probiotics compared to placebo control.The outcome measure was a change in Scoring Atopic Dermatitis (SCORAD) or the Eczema Area and Severity Index (EASI).The search was limited to randomized control trials (RCT) and meta-analyses in the PubMed database.The human filter was applied with the date restriction set to include studies from 2015-2023.Only RCTS not summarized in included meta-analyses were included.Results: The literature search for Vitamin D supplementation yielded 23 results, of which two RCTs and one meta-analysis met the criteria.Probiotic supplementation yielded 41 results of which two RCTs and one meta-analysis met the criteria.All three probiotic studies showed a statistically significant decrease in SCORAD compared to control with a high level of heterogeneity due to the use of different combinations or single strains.One study on vitamin D found a decrease in SCORAD after supplementation compared to control.The dose and duration of supplementation varied between all three studies.Conclusion: Probiotics may be a viable treatment option for AD in children, however, more research on the benefits of specific strains for this condition is needed.The research presented here doesn't support vitamin D supplementation for AD treatment in children.More studies with dose and duration standardization are needed.

Assessing the Effects of Cold Water Immersion, Acupuncture, and Branched-Chain Amino Acid Supplementation on Delayed Onset Muscle Soreness: A Narrative Review
Skylar Tierney, CCNM Student [1], Adam Gratton, MSc, ND [1] [1] Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada Background: Perceived muscle soreness may impede the ability to produce powerful movements, reduce range of motion, and cause biomechanical problems, ultimately decreasing efficiency and increasing risk of injury.Cold water immersion, acupuncture, and branched-chain amino acids (BCAA) supplementation are commonly practiced by athletes under the notion they mitigate muscle damage and accelerate recovery.Evaluating the efficacy of these interventions to reduce subjective reports of muscle soreness following physical activity could allow for superior athletic performance.Methods: Separate literature searches were conducted for each intervention.PICO criteria were defined before conducting a literature search, all of which had the same population and outcome measurements.Study populations were comprised of non-injured adults following a bout of exercise and outcome measures included subjective reporting of delayed onset muscle soreness (DOMS) using the Visual Analogue Scale (VAS).Cold water immersion was compared to passive rest controls, acupuncture interventions were compared to no treatment, and the consumption of BCAAs was compared to placebo controls.Literature searches were limited to PubMed and ScienceDirect.Only trials not included in the summarized systematic reviews and meta-analyses were included.Results: The literature search for cold water immersion yielded 115 results, with two RCTs and one meta-analysis meeting the criteria.Acupuncture yielded 93 results, of which one RCT, one parallel-group trial, and one meta-analysis met the criteria.BCAAs yielded 47 results, with one RCT, one counterbalanced trial, and one meta-analysis meeting the criteria.All interventions were found to significantly improve VAS reports of DOMS.Cold water immersion was most effective 48-72 hours post-treatment, while acupuncture provided fast-acting improvements.BCAA proved most effective when used on days prior to and following exercise.

Evaluating Oral Supplementation of Zinc for Chemotherapy-And Radiation-Induced Oral Mucositis: A Narrative Review
Loreal Legare, CCNM Student [1], Jason Clifford, ND [1] [1] Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada Background: Oral mucositis (OM) creates painful inflammation and ulcerations of the oral mucosa, and is a common side effect of chemotherapy and radiation therapy.On its own, OM should heal after treatment has concluded, but it can last for 2-12 weeks, affecting patients' nutrition and quality of life.Standard care includes topical and oral pharmaceutical interventions, and changes to oral hygiene practices.Zinc, a mineral essential in our body, enhances the immune system, cell signalling, and has been shown to have a relationship with wound healing.The purpose of this investigation is to evaluate evidence on the effect of zinc for chemotherapy and radiation-induced OM.Methods: The following inclusion criteria were defined: 1) population including adults at risk of developing OM due to chemotherapy or radiation, 2) intervention with zinc, 3) placebo comparison group, and 4) outcome reported as reduction in an OM grading scale.The search was limited to the PubMed and Cochrane Library databases and the English language.The Cochrane search was limited to 2018-2023, as the last meta-analysis covered up to 2017.Articles were limited to randomized controlled trials (RCTs) and meta-analyses.Only RCTs not included in the meta-analyses were summarized in this review.Results: The literature search yielded forty-one studies from PubMed and four from Cochrane Library.Six RCTs and one meta-analysis of ten RCTs met the inclusion criteria.Five studies, including the meta-analysis, found benefit in zinc reducing the incidence and/or severity of OM.Two studies found no statistical significance between groups.Conclusion: Evidence suggests that zinc may be helpful in reducing the incidence and/or the severity of oral mucositis, but considerable heterogeneity exists between the studies, and further research is needed.
Funding Sources: No funding was received for the conduct of this research.

Conflicts of Interest:
The authors have no conflicts of interest to declare.[1] Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada [2] University of Guelph, Guelph Ontario, Canada Background: Mental illnesses, such as depression, anxiety, schizophrenia, and bipolar disorder, significantly affect an individual's quality of life and emotional, cognitive, and psychological well-being.The prevalence of mental illness is increasing, making it a public health concern.The Mediterranean diet has been comprehensively studied regarding its benefits on mental health; however, less is known about the individual diet components which contribute to the therapeutic effect.Olive oil has an abundance of health benefits.A longstanding wealth of literature supports olive oil's benefit on cardiovascular health, but its impact on mental health has not been reviewed systematically.Methods: PubMed and OVID MEDLINE databases were searched to identify articles assessing an association between olive oil and mental health conditions.Included in the scoping review were studies that delivered or measured intake of olive oil or one of its constituents.Any outcome measures related to mental health were considered, including incidence, severity, and treatment of mental disorders.The following article types were eligible for inclusion: human experimental and observational studies, animal and preclinical studies, and meta-analyses.Abstracts were screened in duplicate and data were extracted using a piloted template.Data were analyzed qualitatively to assess trends and gaps for further study.Results: The PubMed and OVID MEDLINE search yielded 544 and 152 results, respectively.After deduplication, 552 results remained.After full text screening, 32 studies were eligible for inclusion, including 4 human experimental, 18 observational and 10 animal studies.Observational studies showed varying results, with some showing an increase in symptoms, some showing a decrease, and some showing no impact on mental health with higher intake of olive oil or levels of oleic acid.All human experimental studies and 10 of 11 animal studies showed an improvement of anxiety and/or depression symptoms with olive oil supplementation.Discussion/Conclusions: A deeper understanding of the impact diet patterns, foods, and constituents have on mental health is crucial.Based on these findings, olive oil may benefit mental health outcomes.However, due to the small number of experimental studies, differences between studies in dose, duration, and outcome, more research is needed.
Funding Sources: No funding was received for the conduct of this research.

Conflicts of Interest:
The authors have no conflicts of interest to declare.

The Effectiveness of Mistletoe Injections, Ketogenic Diets, and Yoga on the Quality of Life of Breast Cancer Patients Undergoing Conventional Treatment: A Narrative Review
Madison Peters, CCNM Student [1], Adam Gratton, MSc, ND [1] [1] Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada Background: Breast cancer is the leading cause of cancer in women and is estimated to affect 1 in 8 Canadian women.Conventional treatment, though it is often effective and increases survival, can result in significant adverse effects and

Gutpda Study Protocol-Targeting Maternal Gut Microbiome to Improve Mental Health Outcomes: A Pilot Feasibility Clinical Trial Faith Gallant, OT Reg. Ont., RHN [1], Sophie Grigoriadis, MD, FRCPC [2], Kieran Cooley, ND (non-clinical) [3-6], Neda Ebrahimi, PhD [3]
[1] NCCO Rehabilitation Center, Toronto [2] Sunnybrook Health Sciences, Toronto, Ontario, Canada [3] Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada [4] University Technology, Sydney, Ultimo, Australia, [5] Southern Cross University, Lismore, Australia [6] University of Toronto, Toronto, Ontario, Canada Background: Perinatal depression and anxiety (PDA) is prevalent and affects millions of mothers worldwide.Changes in the maternal microbiome have been documented, but its relation to PDA remain unexplored.Probiotics and fish oil have each demonstrated positive impact on anxiety /depression and microbial profile in non-pregnant adults.Oily fish are a source of Omega-3 Fatty Acids (O3FAs).Demand for O3FAs increases during pregnancy, and women with lower levels are reported to have increased risk for depressive symptoms.Probiotics have only recently gained attention in the treatment and prevention of mental health disorders.No studies have investigated the interaction between both supplements & dietary counselling in women at risk of PDA.Objective: Understand the ease and challenges of implementing dietary and supplemental interventions targeting the microbiome of pregnant women at risk of experiencing PDA.Methods: This is a single-center, partially randomized, placebo controlled, double blind trial with three intervention and one active control arms.A total of 100 pregnant women, with a history of depression/anxiety/PDA, attending Sunnybrook Hospital clinics will be randomized/assigned to one of four study arms.The following interventions are given in each group: Gutopia (dietary counselling +Probiotics + Fish oils), Gutboost (Fish oil and Probiotic), Gutless (Fish oil + Placebo), Active Control (standard care at Sunnybrook).Six study visits (2 during pregnancy and 4 in the postpartum period) must be completed.At each visit women will provide a stool sample, dietary and mental health data.The primary outcomes are recruitment rate, and completion of at least four study visits by each participant.Results: This study has received REB approval from both institutions, as well as Health Canada approval.The trial is expected to move to recruitment phase by April 2024.Discussion: The study has received REB approval from CCNM and Health Canada Approval and awaiting Sunnybrook's REB approval.

Funding Sources:
The study is funded by Lotte & John Hecht Memorial Foundation.Conflict of Interest: Dr. Ebrahimi's salary is supported by Atrium Innovations.Study supplements are provided through inkind support by Atrium Innovations.

The Impact of Interior Built Environment on Student and Employee Experience and Wellbeing: A Review
Madison Arnold, CCNM Student [1], Loreal Legare, CCNM Student [2], Tiffany Turner, ND [1] [1] Canadian College of Naturopathic Medicine, New Westminster, British Columbia, Canada [2] Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada Background: In considering the whole patient, naturopathic physicians pay attention to the patient's context, including their physical, natural, and social environments.The relationship between the built environment and human health is complex, but has implications for physical, cognitive, emotional, and social wellbeing.This review examines the impact of non-structural interior elements on mental health and wellbeing, stress management, cognitive function, and academic and work performance with a focus on the relevance of these findings for student and employee wellness within educational institutions.Methods: A search was performed in PubMed, CINAHL, Web of Science Core Collection, APA PsycInfo, and APA PsycARTICLES databases to identify review articles mentioning the impact of interior/indoor built environments on mental wellness, mental health, stress management, academic and work performance, or cognition.All studies were screened and extracted in duplicate using Covidence.Results: A total of 6,495 studies were screened and 80 studies met the inclusion criteria.Non-structural interior elements such as colour, lighting, shape, temperature, spatial arrangement, furniture, sound, air quality, art, and plants and other nature-based elements were found to have associations with various aspects of mental health and wellbeing, cognition, stress, and academic and work performance.The studies included within the reviews demonstrated a wide range in study quality, context, and methodological design.Discussion: This project increases our understanding of the impact of the interior built environment on wellbeing and performance and provides a starting point for guiding interior design choices in academic and professional work environments.The wide variation in studies makes it challenging to assess overall impact.The focus on singular aspects of the environment leaves room for future studies addressing the impact of these interior elements in combination.Going forward, interdisciplinary collaboration between healthcare and design professionals has the potential to result in indoor environments that promote wellbeing and improve performance.
Funding Sources: No funding was received for the conduct of this research.

Conflicts of Interest:
The authors have no conflicts of interest to declare.

Naturopathic Approaches to Atopic Dermatitis: A Cross-Sectional Audit of Patient Care at a Naturopathic Teaching Clinic
Brennan Dedecker, ND [1], Kieran Cooley, ND (non-clinical) [1][2][3][4] [1] Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada [2] University Technology, Sydney, Ultimo, Australia [3] Southern Cross University, Lismore, Australia [4] University of Toronto, Toronto, Ontario, Canada Background: It is estimated that up to 17% of Canadians will suffer from atopic dermatitis (AD) at some point in their lives.In Ontario specifically, patients with AD have an average of 3.6 publicly funded doctor visits per year to assess and treat their AD.The total cost of AD in Canada is estimated to be 1.4 billion Canadian dollars annually.Given this burden, there is a growing interest in the use of complementary and alternative medicines (CAM) as an adjunct to conventional treatment for AD.Up to 34% of patients will seek out and use CAM therapies at some point to treat their AD, however less is known about the nature of the care that is being provided by CAM professionals, including naturopathic doctors.Therefore, this study aims to describe the different therapies used by naturopathic doctors to support patients with AD.This research may provide useful information in the development of standards of care and practice guidelines for the holistic treatment of AD.Methods: Electronic medical charts from the Robert Schad Naturopathic Clinic (RSNC) were reviewed for demographics, treatments, compliance, and response to treatment.Charts were selected by searching the electronic medical record system of the RSNC between May 1 st , 2018 and Dec 31 st , 2022 for patients with atopic dermatitis in their charted assessment (ICD9 Background: Anxiety disorders are prevalent and disabling conditions.Clinical evidence suggests that nutrition interventions, based on the Mediterranean diet and supplementation of omega-3 fatty acids, can significantly improve symptoms of major depressive disorder; however, the effect of nutrition interventions on clinical symptoms in individuals with anxiety disorders has not been studied.The primary objective of the present study was to assess the feasibility and acceptability of a dietary counselling and omega-3 fatty acid supplementation intervention.The secondary objectives included assessing changes in anxiety symptom severity, diet quality, self-efficacy, mindful eating, quality of life, and biomarkers.Methods: This study was a randomized, wait-list controlled pilot trial delivering a 12-week, biweekly dietary counseling intervention and omega-3 supplementation to 50 adult women with GAD.Participants completed seven individual counselling sessions which included nutrition education, personalized recommendations, mindful eating techniques, motivational interviewing, and goal setting.Questionnaires and blood work were completed at baseline, after the wait period (for those in the waitlist group) and after the intervention.Results: A total of 443 individuals contacted the study within seven months; 50 met criteria for enrollment.The two most common reasons for ineligibility included high baseline diet quality (n=151) and low baseline anxiety symptom severity (n=103).The mean number of sessions attended was 6.4 of 7. Three participants self-withdrew before starting the program and one was lost to follow up.Final questionnaires were completed by 46 of 50 participants.Eighty-four percent of participants reported that they strongly agreed with the statement "My experience during this study was positive".The change in mean anxiety symptom severity score during the intervention period was 26.2 (95%CI 22.94-29.48)to 11.0 (95%CI 8.05-13.87)and during the waitlist period was 29.3 (95%CI 24.73-33.91)to 26.8 (95%CI 22.09-31.56).Diet quality score increased from 7.2 (95%CI 6.32-8.10) to 10.5 (95%CI 9.55-11.49)and OmegaScore increased from 3.58 (95%CI 3.29-3.87)to 7.18 (95%CI 6.35-8.01)during the intervention period.Discussion: Based on pre-specified criteria, this study was both feasible and acceptable.Participation in the intervention was associated with a decrease in anxiety symptoms, an improvement in diet quality and an increase in OmegaScore.These findings lay the foundation for future large-scale studies in this area.

Conflicts of Interest:
The authors have no conflicts of interest to declare.

Maternal Fiber Intake and Perinatal Anxiety and Depression: A Review
Abinaa Chandrakumar [1], Roshni Kohli [1], Faith Gallant [3], Victoria Forte, ND [1], Tiffany Turner, ND [2], Shabnam Rahdar, CCNM Student [1], Rebecca Lester, ND [1], Sholeh Ghayoori, CCNM Student [1], Angelica Brigino, ND [1], Neda Ebrahimi, PhD [1] [1] Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada [2] Canadian College of Naturopathic Medicine, New Westminster, British Columbia, Canada [3] NCCO Rehabilitation, Toronto, Ontario, Canada Background: Dietary fiber can significantly alter gut microbiota composition.The role of gut microbiome in the Gut-Brain Axis and modulation of neuropsychiatric disease is increasingly recognized.The role of antenatal diet, particularly fiber intake, in mitigating maternal mental health disorders remains unexplored.The objective of this review is to investigate the association between maternal fiber intake and perinatal depression and anxiety (PDA).Methods: A literature review of PubMed and Google Scholar was conducted using appropriate keyword/MeSH terms for pregnancy, diet, fiber, and mental health.Observational and clinical trials published between 2015-2021 were included and data pertaining to dietary patterns (DP), food intake, mental health, and demographic data were extracted.The top three fibercontaining food groups (FG) per study were identified using a sum rank scoring system of fiber per 100 grams and fiber per serving size.The consumption of these top three fiber FGs was then ranked for each dietary pattern/group.Mental health outcomes for each study were simplified into three categories of improved, no change, and worsened.The relationship between top three fiber FGs consumed within each DP and mental health outcomes was analyzed using Spearman's Correlation.Results: Thirteen of 52 studies met inclusion criteria.Ten (76.9%) studies assessed DPs (7 examined depression only, two examined depression and anxiety, and one examined anxiety only).Seven (54.9%) studies reported at least one significant positive relationship between mental health outcomes and DPs while 3 (23.1%)reported at least one negative outcome.Three (23.1%) studies compared intake of different food groups between depressed and non-depressed groups.In studies of DPs, the average consumption ranking of the top 3 fiber FGs, bore a significant inverse association with mental health outcomes (r=-0.419(95%CI: -0.672,-0.078))p=0.015.In studies comparing intake of different FGs between depressed and non-depressed groups, consumption of top-ranking fiber foods was higher in the non-depressed groups, but significantly higher in four of the ten high fiber FGs.

Conclusion:
This study reframes findings from recent published studies of maternal diet and mental health outcomes to focus on fiber intake specifically, using a fiber ranking system.A significant correlation between lower intake of fiber and poorer mental health outcomes warrants further investigation in future studies.
Funding Sources: No funding was received for the conduct of this research.

Conflicts of Interest:
The authors have no conflicts of interest to declare.

Current Perceptions and Attitudes Towards Vaginal Seeding in Health Care Practitioners: A Narrative Review
Sonya Arrigo, CCNM Student [1], Neda Ebrahimi, PhD [1] [1] Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada Background: Vaginal seeding (VS) is a microbial restoration procedure applied to babies born via cesarean section (C/S).The process involves transfer of vaginal secretions via a sterile gauze to a newborn's mouth, face and body.It is thought that VS may counteract health outcomes associated with C/S such as obesity, autoimmune disease, and asthma.The American College of Obstetricians and Gynecologists (ACOG) however does not recommend VS outside of the context of institutional review board-approved research protocol.As research supporting the benefits of VS emerges, there is an increased interest amongst obstetricians, midwives, doulas, and nurses for the application of VS to C/S delivered babies.Current gaps in knowledge on long-term outcomes, cost, safety, and challenges of VS preclude wider clinical application.

Funding Sources:
No funding was received for the conduct of this research.Conflicts of Interest: The authors have no conflicts of interest to declare.Arnold et al. | URNCST Journal (2024): Volume 8, Issue 3 Page A5 of A17 DOI Link: https://doi.org/10.26685/urncst.589 Conclusions: The existing literature indicates that cold water immersion, acupuncture, and BCAA supplementation are appropriate interventions to prevent and treat DOMS.The interventions decrease DOMS by varying mechanisms, showing potential for synergistic effects when used in combination.Funding Sources: No funding was received for the conduct of this research.Conflicts of Interest: The authors have no conflicts of interest to declare. https://doi.org/10.26685/urncst.589 Arnold et al. | URNCST Journal (2024): Volume 8, Issue 3 Page A11 of A17 DOI Link: https://doi.org/10.26685/urncst.589 Arnold et al. | URNCST Journal (2024): Volume 8, Issue 3 Page A14 of A17 DOI Link: https://doi.org/10.26685/urncst.589